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A patient is involved in a motor vehicle collision and suffers multiorgan trauma. He is brought to the emergency department by emergency medical services and found to be hypotensive, tachycardic and his abdomen is distended. He is disoriented and confused. He has a Glasgow coma scale of 9 and his legs are cool and the pulses thready. What is the most likely cause of his shock state?

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Peripheral vasoconstriction causing cool extremities is a physiologic reaction to acute blood loss. The cardiac output in neurogenic shock is often increased because the blood pressure is low. In neurogenic shock the body loses its ability to regulate flow to other organs.

In neurogenic shock, the cardiac output is usually normal but there is a low BP. The peripheries are warm and the pulses are palpable.

Individuals will show severely depressed mental findings or paralysis, oliguria and lactic acidosis. Treatment requires combination of inotropes and vasopressors like dopamine.